Existing Medical Conditions

Existing Medical Conditions

For information relating to policies purchased prior to 25 March 2021, please check the PDS provided with your purchase. You can contact us if you need this sent to you again.

For policies purchased from 25 March 2021, see below.

What we mean by an Existing Medical Condition?

An existing medical condition is any medical condition which:
at the time you buy your policy is:
  • chronic; or
  • displaying symptoms; or
  • under investigation; or
  • pending follow-up consultation, treatment or surgery; or where these are recommended or planned; or
  • metastatic; or
  • terminal; or
in the six months prior to the time you buy your policy there has been:
  • treatment by a medical practitioner; or
  • medication prescribed; or
  • surgery.

Automatically covered conditions

We automatically cover you for over 40 existing medical conditions which may exist at the time you buy your policy. Your medical condition is classified by us as an ‘automatically covered condition’ if it’s listed below, provided that you satisfy all criteria listed for that condition - click each condition to view the criteria. You must read this section together with the General exclusions, as these may affect your cover.  

You haven’t received treatment for your acne from a medical practitioner in the three months prior to buying your policy. 

You follow advice in accordance with your medical practitioner (such as to carry EpiPens, antihistamines/other preventative medication at all times) and, at the time you buy your policy, you: 

  • have no other known or underlying respiratory conditions or diseases (for example, asthma); and
  • have not required treatment from a medical practitioner for your allergies in the last six months.

No criteria apply.

At the time you buy your policy, you: 

  • are under 60 years of age; 
  • have no other known or underlying respiratory conditions (including sleep apnoea);
  • haven’t required cortisone medication, except taken by inhaler or puffer; and
  • haven’t required hospitalisation for asthma in the last two years, including as an outpatient.

No criteria apply.

At the time you buy your policy, you haven’t required hospitalisation for benign positional vertigo in the last two years, including as an outpatient. 

At the time you buy your policy, you haven’t had surgery for bunions in the last three months and have no surgery planned. 

At the time you buy your policy, you haven’t had surgery for carpal tunnel syndrome in the last three months and have no surgery planned. 

At the time you buy your policy, you have no ongoing complications, haven’t had surgery for cataracts in the last three months, and have no surgery planned. 

At the time you buy your policy, you haven’t required hospitalisation for coeliac disease in the last two years, including as an outpatient. 

No criteria apply.

No criteria apply.

At the time you buy your policy, you: 

  • were diagnosed more than six months ago;
  • haven't had any complications in the last six months;
  • have no eye, kidney, nerve or vascular complications;
  • have a blood sugar level reading between 4 and 12 or a HbA1C score of 9% or less; and
  • have no known cardiovascular/coronary heart disease.

No criteria apply.

At the time you buy your policy, you have no current ear infection. 

At the time you buy your policy, you've: 

  • no underlying medical conditions (for example, previous head trauma, stroke); 
  • not changed your medication regime for epilepsy in the last 12 months; and 
  • not required hospitalisation for epilepsy in the last two years, including as an outpatient. 

No criteria apply.

Your gastric reflux doesn’t relate to another underlying diagnosis (examples: hernia or gastric ulcer).

At the time you buy your policy, you have no ongoing complications, haven’t had surgery for glaucoma in the last three months, and have no surgery planned. 

The underlying medical cause excludes tumour. 

At the time you buy your policy, you haven’t received treatment from a medical practitioner for Graves’ disease in the last six months. 

The underlying medical cause excludes tumour. 

At the time you buy your policy, you haven’t had surgery for hiatus hernia in the last six months and have no surgery planned. 

At the time you buy your policy, you have no cardiovascular/coronary heart disease. 

At the time you buy your policy, you: 

  • you have no known cardiovascular/coronary heart disease; and 
  • your current blood pressure reading is lower than 165/95. 

The underlying medical cause excludes tumour.

The underlying medical cause excludes tumour.

At the time you buy your policy, you: 

  • were diagnosed more than six months ago;
  • haven't had any complications in the last six months;
  • have no eye, kidney, nerve or vascular complications;
  • have a blood sugar level reading between 4 and 12 or a HbA1C score of 9% or less; and
  • have no known cardiovascular/coronary heart disease.

You have no underlying gastrointestinal or urinary condition. 

At the time you buy your policy, you: 

  • no known cardiovascular/coronary heart disease; and
  • not required hospitalisation for insulin resistance in the last two years, including as an outpatient.

No criteria apply.

No criteria apply.

You haven’t required hospitalisation for migraines in the two years prior to buying your policy, including as an outpatient. 

No criteria apply.

At the time you buy your policy, you: 

  • haven't had any fractures;
  • don't require more than one medication for this condition; and
  • have no other conditions involving the neck or back.

No criteria apply.

At the time you buy your policy, you haven’t had surgery for plantar fasciitis in the last three months, and have no surgery planned. 

At the time you buy your policy, you haven’t required treatment by a medical practitioner for Raynaud’s disease in the last six months. 

At the time you buy your policy, you: 

  • have no other known or underlying respiratory conditions (including Asthma); and
  • haven't required hospitalisation for sleep apnoea in the last two years, including as an outpatient.

Your condition has been confirmed as benign.

You haven’t required treatment by a medical practitioner for trigeminal neuralgia in six months prior to buying your policy. 

At the time you buy your policy, you haven’t had surgery for trigger finger in the last three months, and have no surgery planned. 

No criteria apply.

What should I do if I have an existing medical condition not on the above list?

If you have an existing medical condition that's not listed as automatically covered above or you don't satisfy all criteria for any listed condition, we will not cover you for any claim arising from or attributable to that condition.

You can still buy a policy with us if you have one of these conditions; however, any claims which arise in relation to this condition will be excluded from the policy.

This means, for example, that for claims arising from an existing medical condition that is not automatically covered we will not be able to pay:

  • your medical expenses whatsoever;
  • your evacuation or repatriation;
  • your trip cancellation or rearrangement costs; nor
  • any out of pocket expenses or additional expenses.

If you have an unlisted condition, you are welcome to contact nib Travel Insurance who offer a screening for existing medical conditions. Assessment of your existing medical condition is available online during the quote process or over the phone. You may ring 1300 410 272 to be assessed; just have details of your medical history ready when you call.

What if I develop a medical condition after buying my policy but before I travel?

If you develop a new medical condition (or the symptoms of one) after you buy your policy but before you depart on your trip, you must check with your medical practitioner for written confirmation that you're fit to travel. If you don't get your medical practitioner's written confirmation before you travel, and/or are unfit to travel due to your medical condition, you won't be covered for any claim that arises either directly or indirectly from that condition if you still travel. Don't forget, if you had symptoms of a condition or were undergoing investigations for it at the time you bought your policy, we consider that to be an existing medical condition.

Existing medical conditions - close relatives

Cover is available to you when your travel plans are interrupted when a close relative is hospitalised or dies unexpectedly in Australia or New Zealand as a result of a sudden illness or serious injury, however, there is no cover for loss arising from their existing medical condition(s). Your close relative must be residing in Australia or New Zealand.

At the time of the policy issue, you had to have been unaware of the likelihood of such hospitalisation or death.

Existing medical conditions - other people

We will not pay for claims made under this policy which arise from an existing medical condition suffered by people other than those named on the Certificate of Insurance.

Travelling while pregnant

We can cover pregnant women while travelling provided your trip ends on or before your 26th week of gestation. Although it's not part of the policy requirements, you should discuss your travel plans with your doctor before you make your arrangements. Learn more travel insurance for pregnancy.

This article was written by Travel Insurance Direct.

Full terms, conditions, limitations and exclusions are available in the PDS.

Last updated: 25 March 2021

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